Practice Management

4 Things I Have Learned About Getting the Best Out of Newly Graduated Associate ODs

Steven Faith, OD

Oct. 20, 2021

Your best and most promising associate optometrists often come from the ranks of those recently graduated from optometry school. Practice owners may be surprised at the needs and preferences of these new graduates. I co-teach the Personal and Business Management class at UC Berkeley School of Optometry. Here is what I have learned about the new graduates that may soon be a part of your practice, if they aren’t already.

Be Ready for the Student Loan Debt Conversation
There is a good chance you will find yourself in a conversation about student debt with a new associate who recently graduated.

Keep the conversations professional rather than parental. These new graduates are willing and receptive to empathetic and constructive discussions of managing their debt from someone who has been there and has surrounded themselves with financial professionals in the management of their practice and the building of personal savings.

In our class we introduce the students to financial advisors and bankers to give them a starting point for resources they can consult when the need arises after graduation. Most senior practitioners have their own professional resources for tax consultation, financial planning, legal concerns and just plain life issues. These students would love and appreciate introductions to these professionals. Just make sure they are as contemporary in their own professions as the optometry graduate is in theirs.

For example, these young doctors are not interested in the same two-hour lunch and storytelling approach that you and your CPA have become accustomed to over the years. They also are usually not interested in your attorney if they are not up to speed on contemporary contracts, LLCs or know how to handle the intricacies of contemporary optometry or our business needs.

If you want to make bonus points and show new-grad associates you care, why not pay for the first couple of sessions with these professionals on the new associate’s behalf? Run the fees through the office as a recruiting or staff expense. The cost is minimal to you, but the benefit is huge for the young associate.

Highlight the Ways Beyond W2 Income that You Pay Them
The number one question from new graduates coming to your practice to interview for a job will likely be related to income and benefits, as we all would expect. However, they are thinking in the traditional W-2 sense of income, and not the independent practice sense of income. What do I mean?

We all “run” certain products, fees, services through our offices–what is now becoming more familiar to you all as the “Addbacks” when calculating your EBITDA. Let them know how the business model you employ is different than their Gross Wages on their W2. Academy fees, CE trips, association fees, license and Drug Enforcement Administration (DEA) license fees, or even that new laptop for them they can use at home and VPN into your office to complete patient charts, should be explained to them as a form of indirect payment. They think they are going to need to pay for all of those expenses themselves. Let them know you are willing to assist in these seemingly small costs to your practice, realizing they would comprise a large chunk of the associate’s take-home pay.

If you are a senior practitioner who makes associates pay 100 percent of those fees themselves, I bet you are having a hard time keeping associates.

DEA licenses are roughly $888 for three years. A new graduate has to pay that all at once out of their own pocket. So do you, kind of. It is a practice expense run through the office that you never see. You can pay their DEA fee for a return in guarantee of the number of days per week they work.

If you’re going to Vision Expo anyway, pay for their CE or a portion, or all, of their travel expenses in return for an extra few months in their employment contract. Have you forgotten what it was like getting the swag at all the professional meetings you attended over the years? You might not want another industry-sponsored laptop bag, but many new-graduate associates would.

New graduates have no idea of the “non W2” income that is available to them through your practice until you help them understand these little perks. And it can be a multiple return on investment for you to provide this indirect income in the relationship-builder it provides you with the new graduate.

They Are Young, But Value a Good 401(k) Retirement Plan
If established practitioners want to attract the best graduates, they have to have the best benefits, including retirement plans. And not just the best benefits among what your colleagues and buddies are offering, but the best available. To complain about new graduates going to corporate optometry or the new private-equity managed office down the street amounts to complaining about the good ‘ole days. Established practitioners need to get contemporary in not just their clinical diagnostic offerings and products, but their employee benefits.

Your new associate doctors need and deserve benefits if they do not have access to them already. They need real medical coverage, and not just a $300 per month stipend to find their own.

They Likely Would Prefer to Start & End Their Workday Later–and They Want Their Weekends
Young graduates typically like working after 10 a.m. and into the evening while older doctors like the early shift and want to be done by 5 p.m. Occasional Saturdays are not a problem, but every Saturday would probably not be acceptable to most new graduates.

Keep the office open through lunch. Many young graduates don’t know about lunch hours between 12-2 p.m. like their senior colleagues have grown accustomed to. And they generally like eating at their desks since it gives them a chance to catch up on their social media feeds.

Forget about eight-hour shifts. Change to creative six-hour shifts. Schedule right through traditional lunch periods or have a 30-minute break instead of the traditional two hours from 12-2 p.m. Besides, with the same-day additions or emergencies that are added to all of our schedules, the flashes-and-floaters patient or the corneal abrasion added in the day, six-hour shifts easily become eight in a busy office.

If you pay your associates by the day, change your concept of what a “day” is. If the associate’s “normal” day of patients consists of 15 exam slots per day then calculate a day’s pay by the number of exam slots available per month and divide by 15. They can work more or less and you still only pay them by the new “day,” and you won’t have the problem of figuring out how you pay for five hours or a partial day. It all works out at the end of the month with the new-day count system.

In our office, we pay our associates $500 per day or 15 percent of their total collections–whichever is higher. Through our metrics-tracking technology we know exactly how much each of our eight doctors produce per day, per week, per month and per year. We can even monitor their hourly productions in real time and help them determine which of their days or hours in the day are most productive for them. We use this data to determine an optimum schedule for our associates.

With empathy and a work life that optimizes their natural tendencies, you can create an office in which newly graduated optometrists thrive as associates, and do their part to help you build a profitable practice.

Steven Faith, OD, is a partner of Livermore Optometry Group in Livermore, Calif, and a member of the advisory board of Primary Eyecare Network (PEN). To contact:




*Photo credit, top of page: Getty Images.

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